Monitoring & Evaluation

Indicator tools for public health programs

Plan practical indicators, calculate target progress, check data quality, and translate routine program data into better decisions.

Coverage87.5%On track

Reporting completeness94%Good

Target progress76%Needs review

Data quality score82%Improving

Core M&E Indicator Types

Input

Input indicators

Resources available for program implementation, such as staff, budget, medicines, vehicles, or training materials.

Example: % of facilities with trained staff

Process

Process indicators

Activities completed as planned, such as supervision visits, trainings, outreach sessions, or data review meetings.

Example: # of community sessions conducted

Output

Output indicators

Immediate products of activities, such as people reached, services delivered, commodities distributed, or tests performed.

Example: # of children vaccinated

Outcome

Outcome indicators

Short- or medium-term changes in behavior, coverage, knowledge, service use, or health system performance.

Example: % of pregnant women with 4+ ANC visits

Impact

Impact indicators

Long-term changes in morbidity, mortality, equity, resilience, or population-level health status.

Example: maternal mortality ratio

Indicator Reference Library

Area	Indicator	Numerator	Denominator
Immunization	Vaccination coverage	Children receiving the vaccine dose	Eligible children in target population
Maternal health	ANC 4+ coverage	Women with at least four antenatal visits	Women with a live birth in the reporting period
HIV	Treatment retention	Clients still active on treatment at review point	Clients expected to remain on treatment
Nutrition	Program recovery rate	Children discharged as recovered	Total program exits with known outcome
Surveillance	Reporting completeness	Reports received from reporting units	Reports expected from reporting units
Emergency response	Timeliness of response	Alerts investigated within target time	Total alerts requiring investigation

Program Indicator Groups

Immunization

Penta3 coverage: children receiving the third pentavalent dose divided by eligible children.
Dropout rate: Penta1 minus Penta3, divided by Penta1, multiplied by 100.
Zero-dose children: children who have not received any routine vaccine dose.
Cold chain functionality: facilities with functional cold chain equipment divided by assessed facilities.

Maternal & Child Health

ANC 4+ coverage: women with at least four antenatal contacts divided by women with a live birth.
Skilled birth attendance: births attended by skilled health personnel divided by total live births.
Postnatal care within 48 hours: mothers or newborns receiving timely PNC divided by eligible births.
Modern contraceptive prevalence: women using modern contraception divided by women of reproductive age or eligible population.

HIV & TB

ART retention: clients active on ART at a defined time point divided by clients expected to remain on ART.
Viral suppression: clients with suppressed viral load divided by clients with valid viral load results.
TB treatment success: cured or completed TB treatment outcomes divided by notified TB cases with outcomes.
TB contact investigation coverage: contacts screened divided by contacts listed.

Nutrition

Recovery rate: children discharged as recovered divided by exits with known outcomes.
Default rate: children defaulting from treatment divided by exits with known outcomes.
Vitamin A coverage: children receiving vitamin A divided by eligible children.
Exclusive breastfeeding: infants under six months exclusively breastfed divided by surveyed infants under six months.

Surveillance

Reporting completeness: reports received divided by reports expected.
Reporting timeliness: reports submitted on time divided by reports expected.
Alert verification: alerts verified within target time divided by alerts received.
Specimen adequacy: adequate specimens collected divided by cases requiring specimens.

Emergency Response

Response timeliness: alerts investigated within target time divided by alerts requiring investigation.
Households reached: households receiving response services divided by households targeted.
Referral completion: referred clients who completed referral divided by clients referred.
Stockout rate: facilities with stockout during period divided by assessed facilities.

Indicator Review Questions

Is the indicator actionable? A useful indicator should support a program decision, not only fill a report.

Is the denominator realistic? Weak population estimates can make coverage indicators misleading.

Can frontline teams collect it? Indicators should match available registers, forms, staff time, and digital systems.

Will it be disaggregated? Sex, age, geography, facility, disability, risk group, and partner disaggregation may reveal inequities.

Does it need a target? Targets should be ambitious but plausible, with baseline values and reporting frequency documented.

Data Quality Checklist

Completeness: Are all expected reports, facilities, districts, or records included?

Accuracy: Do source documents match summary reports and dashboard values?

Timeliness: Were data submitted early enough for decision-making?

Consistency: Are indicator definitions stable across months, sites, and partners?

Validity: Does the indicator measure what the program claims it measures?